Affordable Care Act Navigators Bypass Glitches

Nov. 1, 2013 -- The serious problems that plague the federal Affordable Care Act web site have thrown thousands of health insurance "navigators" into uncharted waters. These designated helpers are making do by turning to handwritten applications, telephone hotlines, and outreach efforts, say officials with programs in Ohio, Wyoming, and Nebraska.

"The technical difficulties with Healthcare.gov have led us to direct more traffic to the toll-free number and paper applications than we expected," says Amber Hansen, a coordinator with Community Action of Nebraska. "But culturally, many Nebraskans seem to be more comfortable using the toll-free number than the online service."

Like it or not, that may be the best option at the moment for thousands of Americans who need to apply for health insurance policies for 2014 but have been stymied by technical problems.

Thirty-six states are relying on the federal government to provide the online infrastructure for their residents to apply for coverage. But healthcare.gov has been largely unusable because of major technical problems.

Some of the web sites for the remaining 14 states and Washington, D.C., which are running their own Marketplaces, have had technical problems, too.

The New York Times reported this week that federal web site problems were stopping applications from being properly processed and were preventing some agents and brokers from registering so they could provide coverage.

The government-funded helpers known as navigators, assisters, and counselors don't have a magic wand to help them bypass the technical problems. But navigators have been trained, so they're still able to provide information, often with the help of web sites that explain the system and are still accessible, says Rebecka Brayton, a navigator coordinator with the Wyoming Senior Citizens organization.

"The federal web site has slowed our efforts, but we are working around it until such time it is able to catch up," Brayton says. "We are simply going to paper applications until we can do everything electronically. I have also had great success with the call center and encourage people to use that if they would like to enroll that way."

Obstacles Extend to States

Like Wyoming Senior Citizens, many social service agencies, health organizations, and religious groups have received government grants to offer navigator-type services to their communities. And like other parts of the Affordable Care Act, navigators have become a hot topic in political circles, especially in states dominated by legislators who aren't friendly to the Affordable Care Act.

Florida officials have debated whether navigators will get access to private information. In Ohio, officials created regulations that blocked navigators from quickly becoming certified to do their jobs.

The Ohio Association of Foodbanks, which received a federal grant of more than $3 million to provide helper services through a coalition of 12 organizations, has sent about 32 navigator employees through training and certification, executive director Lisa Hamler-Fugitt says. The association expects to reach the target of 40 helpers soon.

Like her counterparts in Nebraska and Wyoming, Hamler-Fugitt says the problems at healthcare.gov haven't been a major problem for her organization's helpers. That's partly because they're focusing now on reaching out to groups and scheduling one-on-one meetings for November, she says. It also helps that consumers aren't looking to make a quick choice. "This is a major decision for people, and they need to do their homework," she says.

Healthcare.gov can now show various health plan options to consumers who aren't ready to log in but still want to see which options are available. (On healthcare.gov, click on "See Plans Now.")

Help on the Way?

While the navigators try to make the best of the situation, the secretary of Health and Human Services called the rollout "a debacle" this week. Testifying at a House committee hearing Wednesday, Kathleen Sebelius apologized for the frustration Americans have felt because of the "flawed launch of Healthcare.gov."

The Obama administration has brought in a special adviser to lead efforts to fix the system. Jeffrey D. Zients, who was the chief performance officer for the Office of Management and Budget, says it will take until the end of November to work out all the bugs.

As the serious technical problems linger, Ohio's Hamler-Fugitt said the nation has been down this road before.

In 2006, there were huge problems when the federal government began offering new prescription drug benefits through Medicare, and millions of people failed to be enrolled properly. "It was almost a massive failure," she says, but the system made it through the rough patch.

"This is really no different," she says. "When you have a brand new program, I don't care whether it's government or business, it doesn't roll out without glitches."